Again, a lot of
people seem to believe this, but it just ain’t so. In fact there are many forms
of spending that are far more likely to improve health outcomes than health care
spending. Consider, for example, that there is a very close link between health
and wealth. The wealthier you are, the more likely that your health is to be
good. This implies that spending that is likely to improve the wealth creating
capacity of society is also an investment in health. That means things like
education, economic infrastructure, and a reasonable tax burden are all key
determinants of health. So too are public health measures like sanitation, water
quality, environmental protection, preventive measures such as pap smears, etc.,
etc.

The irony is that as
the health care budget expands in Canada, it is crowding out many of these other
forms of public spending. For example, the provinces, who have responsibility in
Canada for the delivery of most services, such as health care, primary,
secondary and post-secondary education, roads, environmental protection, water
provision, etc. have seen health rise from around 30% of provincial program
spending to nearly 50%. In all provinces it is expected to exceed 50% within a
decade. And Canada’s tax burden is about 8-10 percentage points of GDP higher
than the United States, so that our tax burden is uncompetitive with you, our
major market and major competitor, while the health care budget is cannibalizing
scarce public dollars that could be spent on things much more likely to produce
superior population health outcomes. But the politics of health spending is
powerful, and have proven nearly irresistible to date.